This invention relates to a surgical apparatus and more particularly to a surgical instrument for use during arthroscopic surgery, as on the knee joint.
The arthroscope is a small telescope-like device which can be inserted through a portal in the skin into an area such as a knee joint permitting visualization of conditions within the knee joint. The development of the arthroscope has led to arthroscopic surgery in which only small punctures are made in the skin covering the joint. Arthroscopic surgery has several advantages such as rapid return to preoperative activity. The use of very small incisions has an obvious cosmetic advantage, and this surgery has also resulted in low complication rates with a very low incidence of infection.
Because only very small incisions are made during arthroscopic surgery, it is oftentimes difficult to grab small tags and tabs of tissue. It is generally desirable to place tissue under tension, either in a direction toward or away from the arthroscopic portal, for making a subcutaneous cut, so that the cut is straight and clean. Again, because of the small incisions, it is often difficult to apply the desired tension.
During arthroscopic surgery, it is often desirable to introduce a needle, such as a spinal needle, to act as a probe in the vicinity of the surgery. The probe may pierce tissue and is useful in exploring the region prior to making larger incisions. Additionally, it is sometimes desirable to introduce a fluid into the joint being operated upon.
One instrument which is useful during arthroscopic surgery on the knee joint is my Tissue Retractor disclosed in U.S. Pat. No. 4,517,965 issued May 21, 1985. In that patent, I describe a tissue retractor which includes a rigid elongate sheath with a sharpened end which includes a retractable, laterally-projecting barb. The barb remains in a retracted position, flush with the sheath, until a rod is advanced in the sheath forcing the barb to project laterally. This invention requires manufacturing the barb member out of a surgical grade spring steel, along with very precise machining. The manufacture of the Tissue Retractor has proven rather expensive. Furthermore, my prior invention was only capable of the single function of retracting tissue, i.e., tensioning tissue in a direction toward the portal.
It is therefore an object of this invention to provide a surgical apparatus for use during arthroscopic surgery which is able to immobilize flaps and tags of tissue and put them under either retracting or stretching tension for cutting.
It is a further object of this invention to provide an apparatus which is capable of performing several functions within a single incision.
Another object is to provide an apparatus which is readily and accurately manipulated under arthroscopic visualization within a joint.
Yet another object is to provide an apparatus which is useful in introducing fluid into a joint.
It is still a further object to provide an apparatus which may be used as a probe within a joint.
Yet a further object is to provide an apparatus which is inexpensive and easy to fabricate.
Other objects will in part be apparent and in part pointed out hereinafter.